Non-Communicable Diseases (NCDs) otherwise known as the ‘Silent Killer’ has been placed on the backburner while Vanuatu continues to keep, what it seems like its full attention, on COVID-19.
Director of Public Health Services Dr. Len Tarivonda disagrees and adds it is a matter of perception, stating that the Ministry of Health hasn’t lost sight of NCD patients.
“To say NCDs is being pushed aside is a bit misleading but it is true that COVID-19 takes centre stage at the moment but let me reassure everyone that NCDs is still our number one priority so it’s not really pushed aside, but I think we are learning to handle complexities, handling COVID-19 and handling essential service.”
The Director explained that even with the tireless efforts invested in keeping Vanuatu free from the global pandemic, essential services still need to continue, “immunization services for women and children they have to continue, malaria services, all our public health services they have to continue in addition to the ministry of health paying a lot of attention to COVID 19.”
Regarding the optics of awareness, despite not having a single case, COVID-19 alerts has overwhelmed any and all other health caveats, something Nurse Practitioner (NP) Ana Kanas and Acting in Charge of NCD Department Willie Essau of Vila Central Hospital are concerned about.
Nurse Practitioner Kanas said that in a day they see close to 40 NCD patients and as many as 200 in a week, fearing that if there is ever a COVID-19 case, the NCD patients would be the most vulnerable – “So if we have one positive case, all the NCD patients cannot stay here (in VCH) they will need to be moved because if COVID comes it could take their life.”
According to NP Kanas, NCDs have proliferated in Vanuatu and with the ever-looming threat of COVID-19, the lives of the NCD patients could be at risk, “they are a risk factor for COVID, it affects them worse since they already sick.
“NCDs is a problem for Vanuatu, before it wasn’t but now it has become a real issue. A lot have recovered, there is treatment, watch your diet, even now there are young people suffering from NCDs. Youngest person is 4yrs old from Malekula, cause, could be their parents, sometimes it’s just bad luck,” she said.
Even without a global pandemic threatening the most vulnerable citizens, lives continue to be lost through NCDs Mr. Essau explained: “If you’re a risk for diabetes, you just have to look after yourself and your children, but a lot of people have died from NCDs not just old people but young people as well.”
During the interview, there were three people in their early twenties with diabetes at the hospital the Acting in Charge of NCD department recalled, giving testament to the seriousness of NCDs in the country.
What would happen to NCD patients if Vanuatu had a case of COVID-19?
On the ground Nurse Practitioner Ms. Kanas said that NCD patients would need to be relocated if Vanuatu had a positive case of COVID-19.
“If we have COVID, then we have two options to relocate to Freshwota or Nambatri, relocate all the NCD patients. We will need to relocate to keep the NCD patients away from the maternity ward and other wards. The body of a NCD patient body will not be strong enough to fight off COVID so he or she will need to be taken elsewhere.”
NP Kanas added that the NCD patients are currently being trained to self-medicate over a period of 3-4 months, which means they wouldn’t have to expose themselves to any risks.
“We want to train them to get used to that process, plus we give them awareness in case we have a positive case of COVID the NCD patients can stay home and it won’t be a problem since they have been doing it already.”
Dr. Tarivonda assured that if a lockdown was placed in Vanuatu due to COVID-19, the NCD patients and others would not be overlooked.
“We also planning during restrictions or maybe even a lockdown, essential services especially drugs they need to be continued to be provided to patients despite the restrictions and nurses as we know that even the nurses and doctors are very anxious of COVID 19, they are front line staff, there is a lot of awareness at the moment on how the nurses can deal with COVID 19 and at the same time ensuring that essential services are not disrupted.”
Plans in the pipeline to combat NCDs
According to Dr. Tarivonda, there are schematics looking at transforming municipal clinics in Port Vila into extensions of VCH, meaning renovating and upgrading its current state.
“Even if we don’t have any COVID cases in the future, at least these facilities will continue to help us offload NCD patients and the daily outpatient cases that come into the clinic and this has been in the pipeline for quite some time, discussion on how to ensure these municipal clinics can become part of the ministry of health service delivery system and in a way an extension of VCH.”
The Director of the Public Health and Services added that an NCD Hub has also been tossed around the discussion table with a focal point on trained specialists for a variety of age groups.
“Yes we are aware that NCDs are taking a toll on the population of the country, particularly now we are seeing more young people being affected by the disease so we are trying to have some dedicated services for the various age groups being affected,” he said.
“At the moment, we don’t have any specialist for specific age groups but for the services that can be provided we can look into it and strategize this with the building of the new NCD hub that we are planning, it has been in the works for one or two years so hopefully it will be a reality in the future.”